BACKGROUND: Although coagulopathy can be very common in severe traumatic shock patients, the exact incidence and mechanism remain unclear. In this study, a traumatic shock rabbit model with special abdomen injuries wa...BACKGROUND: Although coagulopathy can be very common in severe traumatic shock patients, the exact incidence and mechanism remain unclear. In this study, a traumatic shock rabbit model with special abdomen injuries was developed and evaluated by examining indicators of clotting and fi brinolysis.METHODS: Forty New Zealand white rabbits were randomly divided into four groups: group 1(sham), group 2(hemorrhage), group 3(hemorrhage-liver injury), and group 4(hemorrhage-liver injury/intestinal injury-peritonitis). Coagulation was detected by thromboelastography before trauma(T0), at 1 hour(T1) and 4 hours(T2) after trauma.RESULTS: Rabbits that suffered from hemorrhage alone did not differ in coagulation capacity compared with the sham group. The clot initiations(R times) of group 3 at T1 and T2 were both shorter than those of groups 1, 2, and 4(P<0.05). In group 4, clot strength was decreased at T1 and T2 compared with those in groups 1, 2, and 3(P<0.05), whereas the R time and clot polymerization were increased at T2(P<0.05). The clotting angle signifi cantly decreased in group 4 compared with groups 2 and 3 at T2(P<0.05).CONCLUSION: This study suggests that different abdominal traumatic shock show diverse coagulopathy in the early phase. Isolated hemorrhagic shock shows no obvious effect on coagulation. In contrast, blunt hepatic injury with hemorrhage shows hypercoagulability, whereas blunt hepatic injury with hemorrhage coupled with peritonitis caused by a ruptured intestine shows a tendency toward hypocoagulability.展开更多
背景:小型猪因皮肤组织结构、心血管系统等与人高度相似,所以常被应用于皮肤损伤、血管创伤与美容医学等研究领域。水凝胶作为创伤修复敷料拥有较强的保水性和黏附性等多种优异理化性质,能够为伤口提供隔离湿润和药物释放作用。目的:归...背景:小型猪因皮肤组织结构、心血管系统等与人高度相似,所以常被应用于皮肤损伤、血管创伤与美容医学等研究领域。水凝胶作为创伤修复敷料拥有较强的保水性和黏附性等多种优异理化性质,能够为伤口提供隔离湿润和药物释放作用。目的:归纳和总结水凝胶治疗小型猪不同实验用途创伤修复模型的应用进展,揭示各类小型猪创伤修复模型的发展现状,分析现阶段小型猪创伤修复模型的不足。方法:查阅Web of Science数据库及中国知网从数据库建立至2023年发表的相关文献,设置中文检索词为“小猪,小型猪,微型猪,迷你猪;凝胶,水凝胶;创伤,损伤,伤口,创口”等,英文检索词为“miniature Swine,miniature pig,minipig;gel,hydrogel;injury,wound,lesion,incision”等。共检索到438篇中、英文文献,通过纳入和排除标准共纳入59篇文献进行探讨。结果与结论:①目前用于创伤修复的模型主要有大型动物物种(犬和猪)、兔子及啮齿类动物(大鼠和小鼠),由于小型猪皮肤结构与人类较相似,因此小型猪是创伤修复理想的动物模型。②在体外皮肤损伤模型中,皮肤缺损模型是基础的伤口模型,按伤口缺损深度可分为全层皮肤缺损模型和中厚皮肤缺损模型;烧伤伤口模型和感染伤口模型是在皮肤缺损模型的基础上施加热金属烫伤和细菌培养的多维度模型,具有安全系数高、操作难度低的优点。③在体内创伤修复模型中,小型猪可用作更符合临床疾病病理状态的食管环切模型;在胃穿孔、血管止血模型中,小型猪可观地展示出水凝胶较强的脏器黏附性、止血性能及促进组织再生效应。④在猪的特定部位也有相应模式用途:猪耳通常用来评价水凝胶的药物缓释效果;猪细胞蛋白和猪皮胶原多制备组织来源的复合水凝胶。展开更多
Indirect traumatic optic neuropathy(ITON) refers to optic nerve injury resulting from impact remote to the optic nerve. The mechanism of injury is not understood, and there are no confirmed protocols for prevention, m...Indirect traumatic optic neuropathy(ITON) refers to optic nerve injury resulting from impact remote to the optic nerve. The mechanism of injury is not understood, and there are no confirmed protocols for prevention, mitigation or treatment. Most data concerning this condition comes from case series of civilian patients suffering blunt injury, such as from sports- or motor vehicle-related concussion, rather than military-related ballistic or blast damage. Research in this field will likely require the development of robust databases to identify patients with ITON and follow related outcomes, in addition to both in-vivo animal and virtual human models to study the mechanisms of damage and potential therapies.展开更多
Objective: To evaluate the influence of surgical trauma on liver cancer metastasis. Methods: A mouse model of experimental liver cancer metastasis was established by subcapsule injecting hepatoma ascites tumor cells (...Objective: To evaluate the influence of surgical trauma on liver cancer metastasis. Methods: A mouse model of experimental liver cancer metastasis was established by subcapsule injecting hepatoma ascites tumor cells (H22) into spleen of NIH mice. Simple intrasplenic inoculation, with sham operation, partial hepatectomy, total occlusion of hepatic blood inflow and blood loss and re-perfusion were performed and metastatic effects were observed. Results: There were significant higher metastasis-augmenting effects in sham operation and partial hepatectomy groups. Compared with no-blood transfusion, blood transfusion group was found to be potent to increase intrahepatic metastases. But, neither inhibition nor enhancement with total occlusion of hepatic blood inflow for 20 and 30 minutes was seen. Conclusions: Surgical trauma, especially partial hepatectomy and blood transfusion, are involved in enhancing metastasis, but total occlusion of hepatic blood inflow is not responsible for enhanced liver metastasis in the experimental metastasis model.展开更多
<strong>Purpose of Review:</strong> The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available informatio...<strong>Purpose of Review:</strong> The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available information in the literature and author experience. This review presents a workable framework from the first presentation, epidemiology, classification, investigations, management principles, complications, prognostic factors, final visual outcome and management debates. <strong>Review Findings:</strong> Mechanical ocular trauma is a leading cause of monocular blindness and possible handicap worldwide. Among several classification systems, the most widely accepted is Birmingham Eye Trauma Terminology (BETT). Mechanical ocular trauma is a topic of unsolved controversy. Patching for corneal abrasion, paracentesis for hyphema, the timing of cataract surgery and intraocular lens implantation are all issues in anterior segment injuries. Regarding posterior segment controversies, the timing of vitrectomy, use of prophylactic cryotherapy, the necessity of intravitreal antibiotics in the absence of infection, the use of vitrectomy vs vitreous tap in traumatic endophthalmitis is the issues. The pediatric age group needs to be approached by a different protocol due to the risk of amblyopia, intraocular inflammation, and significant vitreoretinal adhesions. The various prognostic factors have a role in the final visual outcome. B scan is used to exclude R.D, Intraocular foreign body (IOFB), and vitreous haemorrhage in hazy media. Individual surgical strategies are used for every patient according to the classification and extent of the injuries. <strong>Conclusion:</strong> This article examines relevant evidence on the management challenges and controversies of mechanical trauma of the eye and offers treatment recommendations based on published research and the authors’ own experience.展开更多
基金funded by Guangxi Natural Science Foundation(N o.2015GXNSFAA139195)Guang xi Emergency Medicine and Medical Rescue Talent Upland Foundation(No.GXJZ201403)
文摘BACKGROUND: Although coagulopathy can be very common in severe traumatic shock patients, the exact incidence and mechanism remain unclear. In this study, a traumatic shock rabbit model with special abdomen injuries was developed and evaluated by examining indicators of clotting and fi brinolysis.METHODS: Forty New Zealand white rabbits were randomly divided into four groups: group 1(sham), group 2(hemorrhage), group 3(hemorrhage-liver injury), and group 4(hemorrhage-liver injury/intestinal injury-peritonitis). Coagulation was detected by thromboelastography before trauma(T0), at 1 hour(T1) and 4 hours(T2) after trauma.RESULTS: Rabbits that suffered from hemorrhage alone did not differ in coagulation capacity compared with the sham group. The clot initiations(R times) of group 3 at T1 and T2 were both shorter than those of groups 1, 2, and 4(P<0.05). In group 4, clot strength was decreased at T1 and T2 compared with those in groups 1, 2, and 3(P<0.05), whereas the R time and clot polymerization were increased at T2(P<0.05). The clotting angle signifi cantly decreased in group 4 compared with groups 2 and 3 at T2(P<0.05).CONCLUSION: This study suggests that different abdominal traumatic shock show diverse coagulopathy in the early phase. Isolated hemorrhagic shock shows no obvious effect on coagulation. In contrast, blunt hepatic injury with hemorrhage shows hypercoagulability, whereas blunt hepatic injury with hemorrhage coupled with peritonitis caused by a ruptured intestine shows a tendency toward hypocoagulability.
文摘背景:小型猪因皮肤组织结构、心血管系统等与人高度相似,所以常被应用于皮肤损伤、血管创伤与美容医学等研究领域。水凝胶作为创伤修复敷料拥有较强的保水性和黏附性等多种优异理化性质,能够为伤口提供隔离湿润和药物释放作用。目的:归纳和总结水凝胶治疗小型猪不同实验用途创伤修复模型的应用进展,揭示各类小型猪创伤修复模型的发展现状,分析现阶段小型猪创伤修复模型的不足。方法:查阅Web of Science数据库及中国知网从数据库建立至2023年发表的相关文献,设置中文检索词为“小猪,小型猪,微型猪,迷你猪;凝胶,水凝胶;创伤,损伤,伤口,创口”等,英文检索词为“miniature Swine,miniature pig,minipig;gel,hydrogel;injury,wound,lesion,incision”等。共检索到438篇中、英文文献,通过纳入和排除标准共纳入59篇文献进行探讨。结果与结论:①目前用于创伤修复的模型主要有大型动物物种(犬和猪)、兔子及啮齿类动物(大鼠和小鼠),由于小型猪皮肤结构与人类较相似,因此小型猪是创伤修复理想的动物模型。②在体外皮肤损伤模型中,皮肤缺损模型是基础的伤口模型,按伤口缺损深度可分为全层皮肤缺损模型和中厚皮肤缺损模型;烧伤伤口模型和感染伤口模型是在皮肤缺损模型的基础上施加热金属烫伤和细菌培养的多维度模型,具有安全系数高、操作难度低的优点。③在体内创伤修复模型中,小型猪可用作更符合临床疾病病理状态的食管环切模型;在胃穿孔、血管止血模型中,小型猪可观地展示出水凝胶较强的脏器黏附性、止血性能及促进组织再生效应。④在猪的特定部位也有相应模式用途:猪耳通常用来评价水凝胶的药物缓释效果;猪细胞蛋白和猪皮胶原多制备组织来源的复合水凝胶。
文摘Indirect traumatic optic neuropathy(ITON) refers to optic nerve injury resulting from impact remote to the optic nerve. The mechanism of injury is not understood, and there are no confirmed protocols for prevention, mitigation or treatment. Most data concerning this condition comes from case series of civilian patients suffering blunt injury, such as from sports- or motor vehicle-related concussion, rather than military-related ballistic or blast damage. Research in this field will likely require the development of robust databases to identify patients with ITON and follow related outcomes, in addition to both in-vivo animal and virtual human models to study the mechanisms of damage and potential therapies.
文摘Objective: To evaluate the influence of surgical trauma on liver cancer metastasis. Methods: A mouse model of experimental liver cancer metastasis was established by subcapsule injecting hepatoma ascites tumor cells (H22) into spleen of NIH mice. Simple intrasplenic inoculation, with sham operation, partial hepatectomy, total occlusion of hepatic blood inflow and blood loss and re-perfusion were performed and metastatic effects were observed. Results: There were significant higher metastasis-augmenting effects in sham operation and partial hepatectomy groups. Compared with no-blood transfusion, blood transfusion group was found to be potent to increase intrahepatic metastases. But, neither inhibition nor enhancement with total occlusion of hepatic blood inflow for 20 and 30 minutes was seen. Conclusions: Surgical trauma, especially partial hepatectomy and blood transfusion, are involved in enhancing metastasis, but total occlusion of hepatic blood inflow is not responsible for enhanced liver metastasis in the experimental metastasis model.
文摘<strong>Purpose of Review:</strong> The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available information in the literature and author experience. This review presents a workable framework from the first presentation, epidemiology, classification, investigations, management principles, complications, prognostic factors, final visual outcome and management debates. <strong>Review Findings:</strong> Mechanical ocular trauma is a leading cause of monocular blindness and possible handicap worldwide. Among several classification systems, the most widely accepted is Birmingham Eye Trauma Terminology (BETT). Mechanical ocular trauma is a topic of unsolved controversy. Patching for corneal abrasion, paracentesis for hyphema, the timing of cataract surgery and intraocular lens implantation are all issues in anterior segment injuries. Regarding posterior segment controversies, the timing of vitrectomy, use of prophylactic cryotherapy, the necessity of intravitreal antibiotics in the absence of infection, the use of vitrectomy vs vitreous tap in traumatic endophthalmitis is the issues. The pediatric age group needs to be approached by a different protocol due to the risk of amblyopia, intraocular inflammation, and significant vitreoretinal adhesions. The various prognostic factors have a role in the final visual outcome. B scan is used to exclude R.D, Intraocular foreign body (IOFB), and vitreous haemorrhage in hazy media. Individual surgical strategies are used for every patient according to the classification and extent of the injuries. <strong>Conclusion:</strong> This article examines relevant evidence on the management challenges and controversies of mechanical trauma of the eye and offers treatment recommendations based on published research and the authors’ own experience.
